เป้าหมายที่ 3

Small community in Northeast, with medical help from ThaiHealth and Nakhon Phanom University, leads way in scheme that shows results in just six weeks, writes Chairith Yonpiam

Nestled in the heart of the Northeast, the small district of Phon Sawan may seem an unlikely battleground in the country’s fight against chronic illness.

But over the past two months, this quiet community has become a beacon of hope in a struggle against diabetes, a disease that is quietly costing the nation its health and a big share of its budget.

At the centre of the transformation is a pilot programme known as the “Urban Primary Healthcare Project: Proactive Diabetes Prevention and Control,” launched by the Thai Health Promotion Foundation (ThaiHealth) and a research team from Nakhon Phanom University.

Its aim is ambitious as it is urgent: to prevent diabetes at the community level, reduce dependence on medication, and ease the growing financial burden on the universal healthcare system.

What began with just 62 volunteers in Ban Sao Lao, a four-village cluster in Phon Sawan district, is now being closely watched by public health experts across the country.

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WHERE CHANGE BEGINS

“I didn’t even realise sticky rice was a form of sugar,” said Amnuay Suwammajo, one of the participants. “Now, I eat more vegetables and lean meat, and I’ve lost several kilogrammes already.”

Mr Amnuay’s story is far from unique. Among the 62 people involved in the project—50 of whom are women—20 had already been diagnosed with prediabetes and many were classified as being at high risk.

Residents reported visible results: body mass index, and perhaps most significantly, waist circumference dropped and exercise increased.

Wimonrat Saha, a 47-year-old farmer, had not only felt healthier but also noticed how the balance of foods changed for good, she laughed. “But more importantly, I understand that it’s not just about weight—those who are diabetic suffer serious complications.”

This rings true for many as diabetes and related complications account for a high share of deaths and healthcare costs in Thailand: these risks may fall by 10–20% after six weeks for those involved in the programme, according to project researchers.

Thus begins a highly personalised lifestyle change programme, but one that doesn’t look intimidating—because in fact, it isn’t.

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A TEAM BEHIND EVERY STEP

The engine behind this success is a multidisciplinary team drawn from Phon Sawan Hospital. Instead of focusing solely on treatment, they’re redefining healthcare as a partnership between professionals and villagers.

Each week, participants join community-based activities, guided by dietitians, physiotherapists, sports scientists.

The goal: helping people not just lose weight, but gain strength, confidence, and understanding.

“The goal isn’t just weight loss,” said Asst Prof Benjamaya Ployron, Assistant Dean for Elearn Internal Quality Assurance at Nakhon Phanom University, one of the project’s lead researchers. “We’re looking at building muscle, improving mental health and changing how people live. That’s where real prevention begins.”

To keep participants motivated, the group sits in a Line group where they share photos of what they eat, how they exercise, how they feel. There’s even friendly competition—like a weekly leaderboard, whose muscle gains steal the show.

Still, there are challenges. “Some people struggle to afford protein-rich food like meat,” said Kanuyan Kamonruen, a nurse at the hospital. “And others don’t like being told what to eat. So we focus on education and encouragement, not rules.”

That approach is essential since most lifestyles start to see this shift when weighing scales and in their medical statistics.

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THE COST OF DOING NOTHING

What’s happening in Ban Sao Lao isn’t just a feel-good story—it is a financial strategy.

Asst Prof Dr Soranit Siltharm, board member of ThaiHealth, said diabetes and deadly chronic conditions are the most sizeable contributors to Thailand’s healthcare crisis.

In 2015, factors linked to diabetes accounted for nearly two million years of productive human lifespans lost.

Under the universal healthcare scheme, millions depend on essential medication that often continues for life. Diabetes imposes one of the largest financial burdens on the national health system—with patients requiring dialysis, eye treatment, heart treatment, and more.

According to ThaiHealth, diabetes drains an estimated 200 billion baht every year.

“Diabetes is the real silent killer,” Dr Soranit said. “It creeps up slowly, and by the time symptoms show, it’s often too late.”

Since 1973 the country’s healthcare system has improved considerably, but chronic diseases have never stopped rising. The results of the Phon Sawan model, delivered by Nakhon Phanom University and the ThaiHealth Foundation, indicated the programme can be scaled nationally, the savings could be massive, not just in baht, but in lives saved and suffering avoided.

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A PATH FORWARD

At Phon Sawan Hospital, head nurse Patcharaporn Kawansu explains how the proactive diabetes project has helped build a positive attitude within the community.

Instigated by ThaiHealth’s approach, the hospital invites villagers for shared care with medical experts, treating diabetes as an everyday habit—not just medication.

“We’ve always treated diabetes,” Ms Patcharaporn said. “But now we’re preventing it. The combination of group activities, seen, heard and supported has changed everything.”

Rather than leaving patients with medication and a few standard instructions, the project ensures villagers understand:

— “Why they need to move more,”
— “How their meals matter,” and
— “How muscles reduce insulin resistance.”

The programme encourages people to take control of their health, something that often gets overlooked due to traditional practices.

It offers a new direction for primary care nationwide. If scaled up, experts believe rural villages may already hold the answer.